Diego Serrano-Gómez

Background: During the COVID-19 pandemic, synchronous hybrid teaching was implemented in the Nursing Degree at the University of Burgos to enable simultaneous face-to-face (F2F) and online attendance. Although this teaching model has remained of interest beyond the pandemic, evidence comparing educational outcomes according to attendance modality remains limited in nursing education. Objective: To compare educational outcomes, satisfaction levels, and student perceptions associated with F2F and online attendance within a synchronous hybrid teaching model. Methods: An observational, cross-sectional, comparative study was conducted among second-year nursing students enrolled in three theoretical courses (Pharmacology, Research Methodology and Information Systems, and Nutrition and Diet Therapy) during the 2020–2021 and 2021–2022 academic years at the University of Burgos (Spain). Data were collected through knowledge assessments, satisfaction questionnaires, and open-ended survey responses. Comparisons between attendance modalities were performed using parametric and non-parametric tests as appropriate. Mean differences and 95% confidence intervals (95% CI) were reported. p-values were adjusted for multiple comparisons using the Benjamini–Hochberg false discovery rate (FDR) procedure. Results: The association between attendance modality and educational outcomes varied across study units and assessment methods. At class level, the largest differences were observed in Nutrition and Diet Therapy, where F2F students obtained higher knowledge scores than online students (mean differences ranging from 2.41; 95% CI 0.34–4.47 to 3.71; 95% CI 2.13–5.30 points). In end-of-course assessments, mean knowledge scores were higher among predominantly F2F students in all study units and academic years, although none of these differences remained statistically significant after FDR adjustment. Satisfaction results also varied according to study unit, although attention was consistently rated more favorably in F2F classes across all end-of-year evaluations, a finding that remained significant after FDR adjustment. Qualitative findings showed that students associated F2F attendance with greater attention, understanding, and interaction, whereas flexibility, comfort, and organizational advantages were the main reasons for preferring online attendance. Conclusions: Associations between attendance modality, knowledge assessment scores, and student satisfaction varied according to study units and assessment method. In several analyses, students attending F2F classes reported more favourable learning experiences and obtained higher scores than students attending online classes. However, given the observational nature of the study, these differences should be interpreted cautiously. The findings suggest that attention, interaction, and student engagement deserve particular consideration when implementing synchronous hybrid teaching in undergraduate nursing education.

Background/Objectives: Blood donation knowledge is increasingly recognised as a relevant construct in health education research due to its role in supporting voluntary donation and informing evidence-based strategies that promote preventive behaviours and civic engagement. This study aimed to develop and validate the Spanish version of the Blood Donation Knowledge Questionnaire (BDKQ22-Spain) through university–school partnerships. The BDKQ22-Spain consists of 22 multiple-choice items, each with a single correct answer, designed to assess knowledge about blood donation. Methods: Psychometric evaluation was conducted within a quasi-experimental study involving 228 responses from individuals aged 17 to 51 years (M = 24.12, SD = 7.75), comprising high school and university students enrolled in health and education programmes. Results: Factor analysis supported a two-factor structure for the BDKQ22-Spain, confirming its construct validity and reliability (KR-20 = 0.85) for measuring blood donation knowledge in Spanish. The results identified higher levels of knowledge among women, nursing students, and individuals with previous blood donation experience, while lower scores were observed among minors, future teachers, and therapy students. However, both minors and future teachers showed significant improvements following the intervention, reaching levels comparable to those of nursing students. These findings highlight specific knowledge gaps across sociodemographic and academic groups. Conclusions: The BDKQ22-Spain represents a valid and reliable tool for assessing blood donation knowledge, supporting its use in health and education settings to guide future research and targeted educational strategies.

Strengthening healthcare systems requires evidence-based health education strategies that promote preventive behaviours and civic engagement. This study aimed to enhance healthcare awareness and reinforce university–school partnerships between Spain and Brazil through a collaborative project with the Blood Donors’ Brotherhood, focused on promoting voluntary blood donation as a public health priority. Implemented via the Research and Excellence High School's Program, the initiative utilised Service-Learning (SL) and Project-Based Learning (PBL) methodologies to create an impactful health educational intervention. The effectiveness of the intervention was evaluated through a quasi-experimental study involving 228 responses from individuals aged 17 to 51 years (M = 24.12, SD = 7.75). Participants were divided into experimental and control groups, including high school and university students in health and education programmes. The intervention was assessed pre- and post-implementation using a survey based on the Blood Donation Knowledge Questionnaire (BDKQ-Brazil), whose Spanish translation (BDKQ24-Spain) was validated through Factor Analysis. The two-factor BDKQ22-Spain model showed strong reliability (KR-20 = 0.85), supporting its suitability for measuring this construct. The study revealed that minors, future teachers, and therapists had less knowledge about blood donation compared to nursing students. However, post-intervention results showed significant knowledge improvements, reaching levels comparable to those of nursing students. This innovative project demonstrates that university–school partnerships strengthen health education outcomes related to blood donation and promote health promotion, contributing to sustainable healthcare systems, social responsibility, and the overall well-being of diverse student populations.

Background/Objectives: According to the World Health Organization, more than one million deaths each year are attributable to bacterial resistance, making it one of today’s main public health threats that could cause up to 10 million deaths by 2050. In this study, antibiotic prescription rates at primary healthcare centers) within Castile and Leon are analyzed over the period 2013–2023, and some of the sociodemographic variables that might influence the prescription of antibiotics are determined. Methods: A descriptive, observational, ecological study was conducted based on data gathered by Concylia (pharmaceutical information system—Castile and Leon Health Service). Comparable variables (time of prescription and type of health center) and variables of results (Defined Daily Doses per 1000 health center card-holders per day and qualitative antibiotic selection variables) were analyzed. Results: During the first years under analysis, prescription rates increased, followed by a reduction at the start of 2015 that continued up until 2021. Another rise was then recorded, and prescriptions once again reached values in 2023 that were comparable to those observed in 2019 (17.62 and 17.45 Defined Daily Doses per 1000 health center card-holders per day). Throughout Castile and Leon as a whole, there were more prescriptions within urban areas; but when analyzed by provinces, prescriptions were mainly higher in rural areas within most provinces. The percentage of macrolides was higher in urban areas, whereas the percentage of fluoroquinolones was higher in rural areas. Conclusions: The variation was repeated throughout the period under study in a similar way in all the provinces of Castile and Leon and at a national level. Different prescription rates were observed by province within the autonomous region. Moreover, higher prescription rates were observed in the rural areas of most provinces. The data source did not allow linking prescriptions to diagnoses, limiting interpretation.

Background/Objectives: According to the World Health Organization, bacterial resistance is one of the main threats to public health and could within a short time become the principal cause of death. This study proposes to study antibiotic prescription rates at Basic Health Centres (BHC) within Castile and Leon over the period 2013-2023, and to determine which sociodemographic variables might influence the prescription of antibiotics. Methods: A descriptive, observational, ecological study was conducted on the basis of data provided by Concylia (Pharmaceutical information system-Castile & Leon Health Service). Comparable variables (time of prescription and type of Health Centre) and variables of results (Defined Daily Dose per 1000 health-center card-holders per day and qualitative antibiotic selection variables) were analyzed. Results: During the first years under analysis, prescriptions increased, followed by a reduction at the start of 2015 that continued up until 2021, after which a new increase was recorded and they once again reached values in 2023 that were comparable to those observed in 2019. Throughout all of Castile and Leon, there were more prescriptions within urban areas; but when analyzed by provinces, prescriptions were mainly higher in rural areas within most provinces. The percentage of macrolides was higher in urban areas, whereas the percentage of fluoroquinolones was higher in rural areas. Conclusions: The variation was repeated throughout the period under study in a similar way in all the provinces of Castile and Leon and at a national level. Differences were observed in prescriptions between the provinces of the autonomous region. Higher prescriptions rates were observed in the rural areas of most provinces.

The coronavirus disease (COVID-19) pandemic has significantly affected mental health worldwide, highlighting the need for reliable tools to assess emotional impact (cognitive-psysiological repercusiones) and coping strategies. To validate the psychometric properties of an evaluation instrument with an ad hoc design, called the Evaluation Inventory of Cognitive-Physiological Repercussions and Coping Strategies in a Pandemic Situation (EICPCP), which has two scales: “Cognitive and Physiological repercussions arising from the pandemic due to COVID-19” (RCFPC19-13) and “Coping strategies during the pandemic due to COVID-19” (EAPC19-15). A total of 1,629 participants (students, teachers, and healthcare professionals) from Spain and Colombia completed the instrument. Exploratory and confirmatory factor analyses were conducted to assess their structure and reliability. Both exploratory and confirmatory factor analyses supported the five proposed dimensions: cognitive and physiological impacts on the RCFPC19-13 scale, and adaptation, support, and organization on the EAPC19-15 scale. In addition, satisfactory internal consistency, reliability indices, and temporal stability were obtained for both scales. The EICPCP is a valid and reliable tool for evaluating the cognitive-physiological impact of the pandemic and coping strategies employed. This instrument provides valuable insights for clinical research and psychological interventions in pandemic-related mental-health studies..

Nowadays, technological teaching tools, such as virtual labs, have become essential, especially in nursing degrees. These resources help implement practical learning based on self-regulation and it is important to know how satisfied students are with them. This means it is important to study students’ perceived satisfaction with virtual labs in flipped learning experiences, which was the general objective of the present study. The aims of the study were: (1) to determine whether there were significant differences in nursing students’ perceived levels of satisfaction according to the type of subject or gender; (2) to ascertain what strengths and weaknesses nursing students perceived about using virtual labs; and (3) to determine the kinds of feelings (positive, negative or neutral) nursing students had using virtual labs. A mixed research methodology was applied, with a sample of 222 undergraduate nursing students at Burgos University (Spain). There were significant differences in the satisfaction perceived by students depending on the subject. Students reported medium-high satisfaction with virtual labs, although they did note that digital skills are needed to use them and suggested incorporating intelligent assistants. Virtual labs seem to be effective, although further studies are needed.

The exploration of patterns of health beliefs about COVID-19 among nursing students may be beneficial to identify behaviors, attitudes and knowledge about contagion risk. We sought to analyze the variables of risk perception, perceived risk factors, coping style, sense of coherence and knowledge of preventive measures as possible predictors of having suffered from COVID-19. Participants were nursing students from 13 universities in Spain. Sociodemographic and health variables were collected. To test the independent variables, the Perception Risk Coping Knowledge (PRCK-COVID-19) scale was created and validated because there was no specific survey for young people adapted to the pandemic situation of COVID-19. It was validated with adequate psychometric properties. A total of 1562 students (87.5% female, mean age 21.5 ± 5.7 years) responded. The high perception of the risk of contagion, the high level of knowledge and a coping style focused on the situation were notable. Significant differences by gender were found in the coping styles, problem-focused, avoidance and knowledge scales, with women scoring higher in all categories. The multiple regression analysis was significant (F = 3.68; p < 0.001). The predictor variables were the coping styles subscale search for support and the intrinsic and extrinsic perceived risk factors. Our model predicts that nursing students with a social support-based coping style are at a higher risk of becoming infected with COVID-19, based on their own health belief model.

As shown in the previous literature, in view of the future responsibilities of nursing professionals and the consequences for healthcare, it is of great interest to examine their risk perceptions, coping behaviors, and sense of coherency during the COVID-19 pandemic. The purpose of this study is to design and to validate a specific questionnaire that evaluates the factors relating to perceived risk, coping behaviors, and preventive knowledge against COVID-19 infection among nursing students from Spain. This is a psychometric study of a questionnaire’s design and its validation in 1562 nursing students at 16 undergraduate nursing institutions in Spain. An ad-hoc survey was designed by a panel of six experts drawing from the literature. After a trial test, the questionnaire was formed with four scales (perception, risk, coping, and knowledge of preventive practices for COVID-19), with a total of 69 items. The final questionnaire was composed of 52 items grouped into four scales, with good psychometric properties to measure risk perception (Cronbach’s alpha 0.735), factors related to perceived risk (Cronbach’s alpha 0.653), coping behaviors (Cronbach’s alpha 0.80), and knowledge of preventive practices against COVID-19 (Cronbach’s alpha 0.77). This questionnaire, specifically designed and validated for nursing students, is the first to address four important areas in the development of preventive measures against COVID-19.

Background: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. Aim: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. Methods: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). Results: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. Conclusions: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.